An Indonesian lady aged 52 years old presented to the emergency department with a 2-week history of lower backache. One-week later, she developed urine retention followed by bilateral lower limb weakness, and since then, she has been unable to walk. Her medical history, family history, and social history were unremarkable. She has no previous history of trauma or similar presented symptoms. Clinical examination showed spastic paraparesis with hyperreflexia. Blood chemistry showed HbA1c of 11.6, and the fasting blood glucose was 14.2 mmol/l. Contrast-enhanced magnetic resonance imaging (MRI) showed an epidural collection extending from T9 to S1 and occupying predominantly the anterior epidural space, with extension toward the posterior epidural space in the lumbosacral region (Fig. 1a). The provisional diagnosis was Pott’s disease, and lumbar (L) hemilaminectomy at L2 was done to drain the epidural collection. Mycobacterium tuberculosis was not detected by acid-fast bacilli or polymerase chain reaction testing of the specimen. However, the drained epdural collection was positive for penicillin-susceptible streptococci Agalactiae. Blood cultures were negative, and transesophageal echocardiography did not show any vegetations. The patient received intravenous ampicillin for 2 weeks, then switched to oral antibiotics for another 6 weeks, and was referred to the rehabilitation center, where she improved and was discharged after 8 weeks with a walker. A repeat MRI (Fig. 1b) showed a complete resolution of the previously described epidural collection.

Karishma

This study aims to see and determine the effect of transformational leadership and competence of PT Waruna Shipyard Indonesia on employee performance through job satisfaction as intervening variable. This research was conducted at PT. Waruna Shipyard Indonesia, located on Bagan Deli Street, Medan Belawan District, North Sumatra. This research was conducted of the month of August 2019-January 2020. The data analysis tool by structural equation modeling (SEM) with smartpls program. The population is employees at PT. Waruna Shipyard Indonesia in 2019, namely as many as 134 employees. This study used slovin formula for the sampling, calculations sample were respondents is 100 permanent employees of PT. Waruna Shipyard Indonesia. Thus taken 30 respondents outside of the sample to validity and reliability test instrument for testing questionnaires. Based on structural equation modeling (SEM) analysis, transformational leadership and competence have positive and significant effect on employee performance with job satisfaction as intervening variable at PT. Waruna Shipyard Indonesia. The contribution of transformational leadership, competence, and job satisfaction explains the employee performance variable of 0.724 or 72.40%. The remaining 0.276 or 27.60% is effect by other independent variables not examined in this study.

L

Wilsons disease is a rare inherited disorder which is characterized by impaired copper excretion which leads to excessive deposition of copper in many tissues and organs like brain, liver, and eye. This is also characterized by Kaiser-Fleischer ring, low serum ceruloplasmin levels and elevated urinary copper excretion [1]. A 26year male patient came to the neurology department with chief complaints of involuntary tremors of both hands and difficulty in walking in the last one month associated with swaying to one side in the last 20 days. On examination the patient is having Kaiser-Fleisher ring positive and upon further investigation Magnetic resonance imaging brain was performed which revealed the features in favor of Wilson’s disease. And for this condition the patient is treated with chelating agents and benzodiazepines.

Dr venkata rama rao nallani

Therapies highly plays a crucial role for all those children and adults with disabilities. In this article, We aim to research the Special Educators’ Knowledge about Therapies in various special schools in the city of Hyderabad, Telangana, India. A qualitative approach was taken for this purpose. Questionnaires was used to collect the data. It was found that the teachers did not have proper conception on Therapies. The data indicated that the teachers are unaware about the unconventional therapies such as Drama Therapy, Pet Therapy and Laughter Therapy and there benefits when working with CSN. This lack of awareness needs to be addressed for the enhancement of the teacher as well students capabilities.

Husna habib

This research was carried out at SDS Harapan Jakarta. This research aims to unravel the implementation of character education’s values through thematic subject, specifically on Indonesian Language Content. This research uses qualitative descriptive approach to gather research data deeply and thoroughly regarding character education’s value. Data collection was done using interviews, observation, and documentation. Miles and Huberman method was used to analyze data collected with the process of data collection, condensation, data display, and data verification. Triangulation was used to verify the validity of the data. The result of this study revealed that 1) The implementation of character education values in the content of Indonesian Language learning in Class 3 is implemented through reading and writing activities that prioritize the five main values in education according to the Minister of Education and Culture. 2) There are still less-effective efforts to achieve learning objectives. 3) There is still a lack of learning innovations carried out to achieve learning goals. 4) No lesson plans that are not made routinely as a means of evaluating learning. 5) There is still a need for improvement in the application of character education in Indonesian content that is linked to students' real experiences, both through online and offline learning.

Educare: journal of primary education

Objective: Pyrazolopyrimidines are heterocyclic molecules containing nitrogen as the main composition, and hence, they exhibit pharmacological efficacy. They are analogs of purines so that possessing wide applications in the field of medicinal chemistry. The main objective of this study is to synthesize different derivatives of pyrazole-pyrimidine classes by adopting simple methodology as well as by employing green chemistry. The purpose of the synthesis of these molecules is to study the antitumor activity against Ehrlich ascites carcinoma (EAC) cell lines. Methods: After literature studies, it makes us to involve in the research of synthetic organic chemistry, especially to synthesize new compounds of pyrazolopyrimidines. We are reported solvent-free synthesis of pyrazolo [3,4-d]-pyrimidine-thiones through ethyl acetoacetate, hydrazine hydrate, thiourea, and different benzaldehydes. An ionic liquid 2-methyl-imidazolium-oxalate catalyzed the reactions under ultrasonication bath. Both conventional and ultrasonic methods were employed and comparison studies have been made. It was found that ultrasonic method completed the reaction quicker than the conventional method. All the synthesized compounds were confirmed their structures by 1 HNMR, Fourier transform infrared, 13C-NMR, and elemental analysis spectra. The compounds were tested for in vitro anticancer activity against EAC cell lines. Most compounds revealed significant anticancer activity relative to doxorubicin as a positive control with inhibitory concentration (IC50) values. Results: Ultrasonication method is a simple method under which all the reactions were completed at faster time (<7 min) compared to the convention method. Among eight molecules, 8a and 8d completed the reactions at a faster rate. We reported IC50 values of all the molecules, in which 8e and 8g were exhibited excellent potency against EAC cell lines at different concentrations .

Dr ganesh n yallappa

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142, 72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals.

Mediterranean journal of pharmacy and pharmaceutical sciences

Background: Scabies is characterized by the presence of burrows, erythematous papules, and generalized pruritus which is usually worse at night. Recently an upsurge in the incidence of scabies has been reported in many settings, including the area of the study. The study aimed to determine if there is a nexus between scabies and climate change as a risk factor. Methods: This was a case-control study carried out in a Cottage Hospital. Case files of 18, 000 patients who attended the hospital between 2016 and 2019 were reviewed. The diagnosis was mainly clinical, i.e. based on the presence of itching in the typical scabies locations, presence of scabies burrows and history of similar itching in the other members of the patient’s household. 112 cases of scabies were diagnosed within this period. Results: From 2016 to 2019, the incidence of scabies rose from 3 to 50. Prevalence among males was 59.8%, and in females 40.2%, although the difference was not significant (p=0.0.53). Compared to other age groups, prevalence was highest in the 6-17 years age group (37.5%), but the difference among the age groups was also not significant (p=0.84). Conclusions: Within four years (2016-2019), the incidence of scabies had risen from 3 to 50 in the area of the study, being higher in males (59.8%) than females (40.2%), and in children less than 18 years (37.5%). Community survey, prompt diagnosis, adequate treatment and avoidance of overcrowding might help to stem the observed rising incidence of the disease.

Emmanuel umegbolu

Stem cells hold great promise for tissue regeneration and have the potential to treat many incurable degenerative diseases. Cancer stem cells (CSCs), or cancer initiating cells, have the ability to self-renew and differentiate into heterogeneous lineages of cancer cells. Current stem cell therapies face limitations, such as limited stem cell sources, time consumption, tumor formation, and immune rejection upon allogeneic transplantation. Allogeneic stem cell treatments simplify stem cell manufacturing and reduce transplant time, but their therapeutic potential is limited by human leukocyte antigen (HLA)-matched donors. CSCs retain characteristics essential for tissue regeneration. However, several limitations hinder cancer stem cell reprogramming with pluripotent factors. The development of 3D culture models for tissue imitating extracellular matrix in cancer cell lines aims to enhance CSC enrichment. This mini-review focuses on a new strategy for treating incurable degenerative diseases involving in vitro and in vivo 3D cancer models and the induced differentiation of CSCs into mature normal cell types. This allows tissue survival without immune rejection and offers a safe alternative to cancer stem cell reprogramming with pluripotent factors. In conclusion, preservation and banking of allogeneic CSCs offer an alternative, readily available, and safe strategy that can be used to facilitate stem cell-based cell therapy.

Josita alloysius

Whitefly, Bemisia tabaci (Genn.) and yellow mosaic virus disease incidence in mungbean, Vigna radiata (L.) Wilczek is a most serious problem in northern states of India. Bioefficacy of some insecticides and biorational were tested during kharif 2010 to 2011 and 2011 to 2012 at Pulses Research Farm, Department of Genetics and Plant Breeding, CCS Haryana Agricultural University, Hisar. The results revealed that 30 days after sowing minimum whitefly population was recorded in plots, when seeds were treated with dimethoate 5 ml/kg seeds. At three days after spray application lowest whitefly population (1.6 and 6.4 adults/ cage/ plant) was noted in NSKE 5 per cent sprayed plots. At seven days after spray, NSKE 5 per cent and triazophos 0.04% was the most effective in keeping the whitefly incidence and yellow mosaic virus infection low. Triazophos and NSKE did not help in managing the whitefly population at low level up to 10 days after spray application. Spraying of triazophos 0.04% resulted in higher grain yield as well as net profit. Lower dosage of triazophos 40EC at 0.02% enhanced the whitefly population in 2011 to 2012. However, the maximum incremental cost benefit ratio (1:13.41) was obtained in dimethoate 5 ml/kg seed treated plots followed by seed treatment with dimethoate plus spraying of triazophos 0.04% (1:11.93).

Dr. babu lal jat

This study examines the first occurrence of non-toxic dinoflagellate blooming of Gonyaulax polygramma and Chaetoceros sp in Ambon Bay that occurred for almost three weeks in January 2019 and it caused the watercolor became red brown. The objective of this study was to identified phytoplankton species and their abundance that cause red tide in the Inner Ambon bay. Phytoplankton samples were collected, temperature, salinity and Secchi depth were measured simultaneously on the 11th and 21st January 2019 (nortwest monsoon) at fifteen sampling stations in Inner Ambon Bay. The results show that the maximum abundance of G. polygramma, Chaetoceros affinis, C. danicus and C. decipiens were found in the greatest concentration up to 20×109, 9.0x106, 5.8x106 and 3.8x105 cells.L-1, respectively. They were found either in the form of a single cell or in chains. The very high abundance of cells of those species made the waters become red brown but there was no reports of fish killed during this red tide phenomena. This is the first time report of blooming phytoplankton Gonyaulax polygramma, Chaetoceros affinis, C. danicus and C. decipiens occurred in Ambon bay during the dry season where the recorded waters temperature and salinity ranged from 30-32ºC and 29-33 psu, respectively and the secchi depths ranged from 2 to 6m. These results show this is the first report of the red tide phenomena in the Inner Ambon bay during the dry season and it occurred for a long period caused by combination of the high abundance of G. polygramma Stein, Chaetoceros affinis, C. danicus and C. decipiens.

Irma kesaulya

Patients’ knowledge of hypertension and treatment has been found to affect health outcomes of hypertension. This study aimed to assess the impact of therapeutic patients’ education on knowledge of hypertension and lifestyle/dietary modification among hypertensive patients in Nigeria. The study was conducted among 317 hypertensive patients randomized into controlled and intervention groups (158 vs 159, respectively) between March 2021 and February 2022. Baseline knowledge of the patients was assessed and intervention was provided for the intervention group with a structured educational program at a baseline and six months. Descriptive data were presented with a frequency table in percentage while the chi-square test and univariate logistic regression were used to determine the association between categorical variables. Out of the total number of 318 patients, 275 completed the study (response rate: 86.8%) with 136 in the control group and 139 in the intervention group. The mean age of the patients was 59.5 (±12.5) and patients > 60 years (49.5%) were the most frequent age category. The baseline knowledge score of hypertension was 9.8 (±2.6) and 9.3 (±2.6) on a scale of 16 points in the control group and intervention group, respectively (P = 0.060) while at six months 11.9 (±2.3) vs 10.8 (±2.4) (P < 0.001) and 12 months 12.6 (±2.5) vs 9.5 (±2.0) (P < 0.001), respectively. Knowledge of lifestyle/dietary modification in the control group and intervention group at baseline was 7.0 (±2.1) and 6.6 (±2.0), respectively, while at six months 7.5 (±1.5) vs 9.9 (±1.3) (P < 0.001) and at 12 months 7.2 (±1.5) vs 10.4 (±1.2), respectively. Marital status, body mass index, and family history of hypertension were associated with knowledge of hypertension and lifestyle/dietary modification (P < 0.001). The educational intervention provided was found to be associated with a significant improvement in knowledge of hypertension and lifestyle/dietary modification. The marital status of the patients, body mass index and family history of hypertension influenced patients’ level of knowledge.

Mediterranean journal of pharmacy and pharmaceutical sciences

Liposomes are a novel drug delivery system (NDDS), they are vesicular structures consisting of bilalyers which form spontaneously when phospholipids are dispersed in water. They are microscopic vesicles in which an aqueous volume is entirely enclosed by a membrane composed of lipid bilayers. NDDS aims to deliver the drug at a rate directed by the needs of the body during the period of treatment and direct the place of action. Liposomes are colloidal spheres of cholesterol non-toxic surfactants, sphingolipids, glycolipids, long chain fatty acids and even membrane proteins and drug molecules or it is also called vesicular system. It differs in size, composition and charge and drug carrier loaded with variety of molecules such as small drug molecules, proteins, nucleotides or plasmids etc. Few drugs are formulated as liposomes to improve their therapeutic index. Hence a number of vesicular drug delivery systems such as liposomes, niosomes, transfersomes and pharmacosomes are developed. The focus of this chapter is to the various method of preparation, characterization of liposomes, advantages and applications, etc. Liposomes for Drug Delivery - liposomes

Kamal singh

Computer as a revolution left no area of life untouched in the present world. It is of tremendous help in all field of life. Hence, the knowledge of computer is a necessity for existence of everybody in this global village. The invention of computer has transformed our simple manual works to sophisticated life of automated works to meet the global demand for the higher productivity and increased efficiency with high precision. Computer is increasingly becoming compulsory in nearly all fields of studies, not because of anything but its accuracy and versatility in processing data. Many tasks at home or office are being automated rapidly with computer. Thus it is becoming apparent that in whatever discipline or working sector, the computer is now a very vital tool for efficiency improvement and precision of job or task execution. This is designed to meet the prerequisite need of everybody that are interested and wish to know about computers science and computing in general. A computer is an electronic device, operating under the control of instructions stored in its own memory. These instructions tell the achine what to do. The computer is capable of accepting data (input), processing data arithmetically and logically, producing output from the processing, and storing the results for future use. Most computers that sit on a desktop are called Personal Computers (PCs). The "computer" is an ensemble of different machines that you will be using to get your job done. A computer is primarily made of the Central Processing Unit (usually referred to as the computer), the monitor, the keyboard, and the mouse. Other pieces of hardware are commonly referred to as peripherals. In everyday life activities, we process data or encounter cases of data processing. A typical example of data processing is the generation of statement of student result from the marks score in an examination and continuous assessment. It is essential to know that information is as good as the data from which it is derived, and the transformation process which they are subjected to. Meaningless data or inappropriate processing produces wrong information. Thus computer gives you results corresponding to what data you supply and how you process it (i.e. ëgabbage- in, gabbage-outí) Summarily, the intelligent performance of a computer depends on correctness of input data and the intelligence performance of the human being that drives it.

Kamal singh

The strategy is a means of establishing the organisation's purpose in terms of priorities for resource allocation, action programs and long term objectives (Grant 2005). Chandler (1962) defines strategy as determining the primary long-term goals of an organisation, the adoption of courses of action, and the allocation of necessary resources. Besides, the strategy also focuses on allocating resources in relation to the organisation and its environment (Schendel & Hatten 1972). The strategy also pertains to the top management's decisions pertaining to its scope and the future direction. Such strategy covers an action plan on the organisation's future, commitments to specific products, services, and the markets.

Zamzam abdelazim

The kidney contains mineral deposits in various phases of calcium salts, such as calcium oxalate and calcium phosphate. Calcium hydrogen phosphate dihydrate (CaHPO4.2H2O) / brushite is a stable form of calcium phosphate, which exists in the form of kidney and bladder stones. The study aimed to explore the possible morphological features of brushite crystals. The study was carried out on a glass slide under a microscope to observe the growth patterns of these crystals. For this purpose, a drop of gel medium (sodium meta silicate solution + 1M orthophosphoric acid solution) at pH 4.99-5.09 was placed in the middle of a glass slide and converted into a gel. A 1M calcium chloride drop was added to form the gel adequately. The glass slide was observed under a microscope till it was completely dried. Calcium hydrogen phosphate dihydrate was formed as elementary needles, needle clusters, an assemblage of needles with platy crystals, plates with spatial branches, radiating assemblage of platy crystals, star shape crystals and tetragonal bipyramidal. The Current study provides brushite crystallisation phases on glass slides for the first time. It may also be used as a model to evaluate prophylactic management against renal stones through in vitro assessment of crystal growth and aggregation inhibition and modulation of developing or developed crystals by using different natural products. However, it was a preliminary study with no quantitative or statistical analysis.

Dr. salman ahmed

Background/Objectives: Healthcare discrimination poses significant challenges to the health-related quality of life (HRQoL) of people living with type 2 diabetes (T2D). However, the role of social support in alleviating these effects has not been fully explored. Drawing on Cohen and Wills’ social support buffering model, this study examined whether social support moderates the association between healthcare discrimination and HRQoL among individuals with T2D. Methods: We analyzed data from 5180 adults with T2D enrolled in the All of Us Research Program. Healthcare discrimination was assessed using the modified Everyday Discrimination Scale (mEDS), social support with the Medical Outcomes Study Social Support Survey (MOS-SSS), and HRQoL (physical and mental domains) with the PROMIS Global Health Scale. Moderation analyses were conducted through linear regression models. Results: Greater exposure to healthcare discrimination was associated with poorer physical and mental HRQoL. Social support demonstrated a significant moderating effect on mental HRQoL: as social support increased, the negative association between healthcare discrimination and mental well-being weakened. However, this buffering effect was not observed for physical HRQoL. Conclusions: Findings suggest that social support can mitigate the adverse mental health consequences of healthcare discrimination among individuals with T2D. Interventions aimed at strengthening social support networks warrant investigation as potential strategies to improve the mental HRQoL of people with T2D who encounter discrimination in healthcare environments.

Emmanuel ekpor

Implementation of Statistical Process Control (SPC) techniques in food and beverage industry are crucial to deliver consumable product that meets customer expectations. This study investigated industrial pH forecasting and process stability in a syrup manufacturing facility. We analyzed 1,247 pH observations with three objectives: (1) Quantify instability via control charts, (2) Model pH dynamics using Seasonal Autoregressive Integrated Moving Average (SARIMA) and Classification And Regression Trees (CART), and (3) Develop diagnostic frameworks for unstable processes. Methodologically, Exponentially Weighted Moving Average (EWMA) charts assessed stability; Box-Cox transformed SARIMA (λ=2) with seasonal differencing was used for forecasting; CART identified variable importance. Control charts revealed profound instability: 83.3% of points violated 3σ limits; run tests significant (p<0.001). For SARIMA, (1,0,1)(0,1,1)₁₂ achieved significant parameters (p<0.0001) with improved residual diagnostics versus non-seasonal ARIMA, though minor autocorrelation remained at lag 12 (p=0.003). CART explained training R²=18.86% and test R²=17.93% of pH variation, identifying filling weight and sodium benzoate as key predictors. Crucially, this study demonstrates that forecasting retains diagnostic utility even in unstable environments: SARIMA residuals provide seasonal fingerprints of assignable causes, while CART thresholds guide intervention priorities. SARIMA(1,0,1)(0,1,1)₁₂ demonstrated superior residual properties: eliminated back forecast warnings (present in ARIMA), reduced autocorrelation at lag 24 (p=0.017 vs 0.040), and explicitly modeled 12-period seasonality. While process instability persists, SARIMA provides diagnostic fingerprints of assignable causes through seasonal parameters (SMA₁₂=0.9846, T=513.12) and residual patterns. We conclude that SARIMA offers enhanced short-term forecasting capability, but process intervention remains essential for reliability. The study advocates for integrated instability-informed forecasting combining SARIMA diagnostics, real-time control charts, and expanded sensor deployment.

Mostafa eissa

Object: The main purpose of the research is to develop modern tools for insurance management in the global economic crisis, to make an objective assessment based on a critical analysis of existing ones, to identify situations that could lead to international economic, social, and natural threats. It is made some recommendations for the development of insurance calculations for the republic of Uzbekistan. Methods: Methods for reforming modern calculation of insurance tariffication are recommended by means of theories of probabilities, statistical and mathematical analysis, and foreign advanced countries practical types of summarizing. Findings: While making an analysis, it has found that modern tools for the insurance management of Uzbekistan are needed. We proved this by the results of the modern calculation of insurance. For the development of the insurance market of Uzbekistan, it should be analyzed by means of penetration and density of insurance premiums, making the deepest calculation of risks of the economy of Uzbekistan, and using the main principles and formulas of the theory of probability. Conclusions: In the end, we can take some results, and give some recommendations such as using the tools of theories of probabilities can help us find the main risks of economy, it’s powers of influences of the market economy, statistical and mathematical analysis also add some practical, objective results for making under control of any types of insurance risks

Ikboljon odashev mashrabjonovich

Medicinal plants have been known for thousands of years and are highly esteemed worldwide as a rich source of therapeutic agents for preventing and curing diseases. Nowadays, a large number of the population suffers from gallstones. The gall stones problem is increasing significantly due to changes in living styles and conditions, i.e. industrialization and malnutrition. Medicinal plants have been used for centuries due to their cultural acceptability, efficacy, safety and lesser side effects than synthetic drugs. The review aims to gather information on the plants utilized in various parts of society against gallstones. The information is useful for ordinary people and the scientific community to carry out further phytochemical, pharmacological and toxicological studies to discover new, effective and safer molecules against gallstones.

Dr. salman ahmed